Vancouver, B.C. [December 20, 2012]: Homelessness and a history of childhood sexual abuse place Vancouver street involved youth at great risk of intravenous injection drug use and potential transmission of HIV and hepatitis C, according to a pair of new studies from researchers at the BC Centre for Excellence in HIV/AIDS (BC-CfE) and the University of British Columbia.

The landmark studies funded by the US National Institute on Drug Abuse and the Canadian Institutes of Health Research were aimed at identifying why some high-risk youth initiate injection drug use while others do not. Results published in the peer-reviewed Journal of Adolescent Health found that youth who were homeless were almost twice as likely to inject drugs than youth who were not homeless.

In a separate study published in the peer-reviewed journal Preventive Medicine, researchers found those reporting childhood sexual abuse were more than two-and-a-half times as likely to start injecting drugs as compared to those who had no history of such abuse.

“These are among the first studies to identify early life experiences and subsequent environments that clearly contribute to initiation of injecting drug use,” said Dr. Evan Wood, Canada Research Chair in Inner City Medicine at the University of British Columbia and senior author of both studies. “This research underscores the urgent need for evidence-based interventions to address homelessness and child abuse, as well as the immediate expansion of evidence-based addiction treatment services for high risk youth.”

Research for both studies was derived from the BC-CfE’s At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth in Vancouver aged 14-26 years.

Investigators for the Journal of Adolescent Health study interviewed 422 street-involved youth between September 2005 and November 2011. Researchers led by Dr. Scott Hadland, chief resident in pediatrics at Harvard University-affiliated Boston Children’s Hospital, studied 395 street-involved youth from October 2005 to November 2010 for Preventive Medicine.

“There are serious medical harms associated with injection drug use, including the transmission of HIV and hepatitis C,” said Dr. Kora DeBeck, lead author of the Journal of Adolescent Health study and a post-doctoral fellow at the BC-CfE and UBC. “While overall rates of injection drug use are down in Vancouver, there is increasing evidence that expanding addiction treatment interventions and providing other tools like supportive housing can intervene to further reduce rates of injection drug use among street youth.”

Researchers closely examined Vancouver street youth behaviours over time in an effort to untangle the mystery of why some youth choose to begin drug injecting while others do not. They also identified key risk factors that can be targeted for implementing treatment and prevention programs.

“Homeless youth and youth at risk need both housing and access to youth-focused and integrated services including education, employment training and in some cases, addictions, mental health and life skills,” said Rob Turnbull, President and CEO of Streetohome Foundation, an organization dedicated to providing access to safe, decent, affordable housing with support services for homeless people in Vancouver. “This research highlights that youth may be particularly vulnerable to the harms associated with homelessness. The goal of supportive housing is to address these harms by providing youth with stable housing, a sense of belonging, opportunities for improved health behaviours and an increased quality of life.”

The BC-CfE is actively working to support expanded addiction treatment in B.C. Through his Canada Research Chair at UBC, Dr. Wood is leading the St. Paul’s Hospital Goldcorp Addiction Medicine Fellowship, a partnership with St. Paul’s Hospital, the Urban Health Research Initiative of the BC-CfE, and the Division of AIDS at UBC. The Fellowship will address a critical lack of skilled addiction medicine specialists in B.C. by providing one year of specialty training in addiction medicine.

B.C. is a global leader in urban health research and evidence-based interventions to fight HIV and AIDS. As a result of implementing the BC-CfE pioneered Treatment as Prevention strategy, which involves widespread HIV testing, the provision of highly active antiretroviral therapy (HAART) where medically eligible, and engagement into care, new HIV diagnoses fell from approximately 900 cases per year in the early 1990s to 289 in 2011. B.C. has experienced a similarly dramatic decline in new HIV cases attributable to injection drug use, from more than 400 in 1996 to 50 in 2010.

About the British Columbia Centre for Excellence in HIV/AIDS

The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS and to improve the health of British Columbians living with HIV through developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses.

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